Premenstrual Syndrome and Premenstrual Dysphoric Disorder: Quality of Life and Burden of Illness

Andrea J. Rapkin; Sharon A. Winer


Expert Rev Pharmacoeconomics Outcomes Res. 2009;9(2):157-170. 

In This Article

Burden of Illness

Although PMS/PMDD is a recognized disorder, little is known about the economic impact of this prevalent condition. Measuring the burden of illness is an area of great interest to public health experts, policy makers and third-party payers. Such measures are used to describe the general state of health of the population and to establish public health goals, to determine the allocation of healthcare resources, and to evaluate the potential costs and benefits of treatments for individuals.[60]

Burden of illness is generally assessed by three components: increased direct medical costs, decreased occupational productivity, and the impact on the HRQoL. The economic sequel of medical conditions is commonly evaluated using the outcome measures of healthcare utilization, worker productivity and absenteeism. Healthcare utilization represents the direct cost associated with health services delivery, including the fees for professional services, medications, diagnostic and therapeutic tests and procedures, as well as health facilities usage. Worker productivity and absenteeism reflect the indirect costs of medical conditions, impacting society and the employer. Worker productivity also includes measures of efficiency while at work, which may be influenced by the effects of a disease, or its treatment, on physical, psychological and intellectual functioning. In addition to the direct and indirect economic costs of an illness, the burden of illness includes the functional impairment that contributes to the individual's HRQoL. The Center for Disease Control (CDC) defines HRQoL as a person or group's perceived physical and mental health over time. It is often used as a measure of how chronic illness interferes with a person's day-to-day life and to determine the effects of treatment.[101] The HRQoL has been shown to be lower in women with PMS than it is in nonaffected women in the community.[61]


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